Diagnostic Delays in Spasmodic Dysphonia: A Call for Clinician Education



      Spasmodic dysphonia (SD) is a rare but often debilitating disease. Due to lack of awareness among practitioners and lack of well-defined diagnostic criteria, it can be difficult for patients with SD to receive a diagnosis and subsequent treatment. There is currently no literature documenting the efficacy of the medical community in recognizing and diagnosing this disorder. We aimed to quantify the patients' experiences with obtaining a diagnosis of SD.


      One hundred seven consecutive patients with SD completed questionnaires about their experiences with SD. Patients were recruited either during outpatient laryngology visits or during participation in a National Institutes of Health funded study investigating SD.


      It took patients an average of 4.43 years (53.21 months) to be diagnosed with SD after first going to a physician with vocal symptoms. Patients had to see an average of 3.95 physicians to receive a diagnosis of SD. Patients (31.4%) had been prescribed medications other than botulinum toxin to treat their symptoms. Patients (30%) attempted alternative therapies for treatment of SD, such as chiropractor or dietary modification.


      Despite advances in diagnostic modalities in medicine, the diagnosis of SD still remains elusive. Objective criteria for the diagnosis of SD and increased clinician education are warranted to address this diagnostic delay.

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        • Ludlow C.L.
        • Adler C.H.
        • Berke G.S.
        • et al.
        Research priorities in spasmodic dysphonia.
        Otolaryngol Head Neck Surg. 2008; 139 (Review): 495-505
        • Schweinfurth J.M.
        • Billante M.
        • Courey M.S.
        Risk factors and demographics in patients with spasmodic dysphonia.
        Laryngoscope. 2002; 112: 220-223
        • Sharma N.
        • Franco Jr., R.A.
        Consideration of genetic contributions to the risk for spasmodic dysphonia.
        Otolaryngol Head Neck Surg. 2011; 14: 369-370
        • Jankovic J.
        • Tsui J.
        • Bergeron C.
        Prevalence of cervical dystonia and spasmodic torticollis in the United States general population.
        Parkinsonism Relat Disord. 2007; 13: 411-416
        • Stacy M.
        Epidemiology, clinical presentation, and diagnosis of cervical dystonia.
        Neurol Clin. 2008; 26 (Review): 23-42